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Medical Policy Update: Ambulatory Event Monitors and Mobile Outpatient Cardiac Telemetry

Effective May 20, 2021, Horizon BCBSNJ will change the way we consider certain professional claims based on updates to our medical policy, Ambulatory Event Monitors and Mobile Outpatient Cardiac Telemetry.


Claims submitted for services provided on and after May 20, 2021 to members enrolled in Horizon BCBSNJ Medicare Advantage plans (including Braven Health℠ plans) will be processed as follows.

  • Regardless of the submitted diagnosis code(s), information will be requested to help us determine the medical appropriateness of the services represented by CPT® codes 0497T, 0498T, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248.

  • Based on the submitted diagnosis code(s), information may be requested to help us determine the medical appropriateness of the services represented by CPT codes 33285, 33286.

  • Following our review of medical record information, these codes may be denied as not medically necessary.

CPT® is a registered mark of the American Medical Association.

Published on: April 19, 2021, 11:26 a.m. ET
Last updated on: April 15, 2021, 10:25 a.m. ET